中西医结合治疗少精子症的临床研究

目的：观察补肾益精汤联合枸橼酸他莫西芬、甘草锌和维生素E对肾精亏虚证少精子症患者精子密度的影响及临床疗效。方法将450例少精子症患者按数字表法随机分为三组，治疗组150例采用补肾益精汤联合枸橼酸他莫西芬、甘草锌、维生素E治疗；对照Ⅰ组150例采用补肾益精汤、甘草锌和维生素E治疗；对照Ⅱ组150例采用枸橼酸他莫西芬、甘草锌和维生素E治疗。三组均治疗3个月，治疗不足3个月其配偶受孕者终止治疗，治疗3个月后其配偶仍未受孕，继续观察3个月统计受孕率，统计分析三组治疗前后精子密度等精液质量其他指标（精液量、pH值、活动力、活动率、正常形态率）的变化。结果治疗组、对照Ⅰ组、对照Ⅱ组总有效率分别为90．21％、85．11％、72．22％，治疗组总有效率高于对照Ⅰ组（χ2＝9．53，P＜0.05）和对照Ⅱ组（χ2＝23．38，P＜0．01）；治疗组、对照Ⅰ组、对照Ⅱ组配偶受孕率分别为42．66％、25．53％、20．83％，治疗组患者配偶受孕率明显优于对照Ⅰ组（χ2＝9．26，P＜0．01）和对照Ⅱ组（χ2＝15．78，P＜0．01）；治疗组治疗后精子密度、活动力、活动率、精子正常形态率明显优于治疗前（ t＝-22．22、-18．07、-33．48、-28．46，均P＜0．01）。结论补肾益精汤联合枸橼酸他莫西芬、甘草锌和维生素E能明显改善肾精亏虚证少精子症患者的精子密度及精液质量，显著提高其配偶受孕率。

Clinical study on treatment of oligospermia with traditional Chinese and western medicine

Objective To observe the clinical efficacy and sperm density of Bushen Yijing decoction and tamoxifen,zinc and vitamin E in treating oligospermia with kidney deficiency syndrome .Methods 450 patients with oligospermia were randomly divided into 3 groups.150 patients of the treatment group were treated by Bushen Yijing decoction,tamoxifen,zinc and vitamin E,150 patients of the control group I were treated by Bushen Yijing decoction , zinc and vitamin E,150 patients of the control group II were treated by tamoxifen ,zinc and vitamin E.3 groups were treated for 3 months,pregnancy terminating of treatment and otherwise continued to observe for 3 months after the end of treatment,the sperm density and other sperm parameters （sperm amount,pH,sperm motility,sperm survival rate, sperm normal modality rate ） were evaluated before and after treatment .Results The total effective rates of the treat-ment group,control group I and II were 90.21%,85.11%,72.22%respectively.The total effective rate of the treat-ment group was higher than that of the control group I （χ2 =9.53,P〈0.05） and II（χ2 =23.38,P〈0.01）.The pregnancy rates of the treatment group ,control group I and II were 42.66%,25.53%,20.83%,respectively.The pregnancy rate of treatment group was significantly better than that of the control group I （χ2 =9.26,P〈0.01） and II （χ2 =15.78,P〈0.01）.There were significant differences between before and after treatment on sperm density , sperm motility,sperm survival rate and sperm normal modality rate in the treatment group （ t=-22.22,-18.07,-33.48,-28.46,all P〈0.01）.Conclusion Bushen Yijing decoction combined with tamoxifen ,zinc and vitamin E can evidently improve the sperm density and other sperm qualities and conception rate of oligospermia with kidney deficiency syndrome .